TW: suicide, MH ableism - long conversation about suicide w Matt

[probably triggering - suicide mentions all over the place, as well as forced hospitalization]Allison Preach.------------------ · 2Maureen And don't say it's "a permanent solution to a temporary problem." Some people's severe depression has lasted decades.------------------ · 2Matt Wow, I've never disagreed with you so strongly on any issue before. It's also completely against public health standards for how to talk about suicide. http://www.washingtonpost.com/.../suicide-contagion-and.../------------------Belenen This is not at all the same thing. I'm not implying suicide is good, I'm saying that scolding people is bad.------------------Matt I read your LiveJournal post. There is never a point at which I would tell someone that if that's their decision, I'm just going to be okay with it and say goodbye. I don't believe that's right at all.------------------Belenen Well, that's you. If I was suicidal, such an act of kindness and respect would be far better for me than anything else. If someone decided to tell me not to do it or pep-talk me out of it that would make me want to do it WAY more because they'd be proving that the world is a selfish place that does not care about my feelings.------------------ · 1Matt I don't think it's in any way selfish to try to stop someone from ending their life.------------------Matt And I don't see letting it happen as an act of kindness and respect at all.------------------Belenen So, don't tell me not to do it unless you want to push me closer. And I'm pretty sure that is true for a lot of people. Empathy is ALWAYS a better choice than scolding, bossing, and using platitudes.------------------ · 1Matt I wouldn't scold or boss you or use platitudes. But I'd use all the tools I know of that might actually WORK to get you to stop. I don't believe it's ever okay to just let it happen.------------------Belenen I believe people have the right to their own bodies and deciding their own destiny. I will respect other people's choices even unto death, and I want that for me as well.------------------Matt I think that suicide is rarely, if ever, a "decision" that one makes if their full mental faculties are available to them at the time. I basically see it as a consent issue. Can you really consent to end your own life? I have very serious doubts about that.------------------Belenen I don't think people lose the rights to handle their own bodies because they might have impaired judgement. Yes, I absolutely can consent to end my life, because my consent is all that Matters! It's MY body, I decide whether or not I will continue to inhabit it.------------------H. D. I view suicidal ideation as a kind of stockholm syndrome of your own brain. It's one of the very very few instances (maybe only) in which I do think that helping someone could very well be doing the things they don't want. I would always do it compassionately, but I can't let someone I love hurt themselves because their brain is tricking them into hating themselves and their existence. I hope you know I don't take that attitude lightly, because I really highly value respecting people's autonomy.------------------ · 2Matt When I was 19 years old, I had a good friend try to commit suicide while she was on the phone long distance with me. She was in Colorado and I was in Vermont. It was about 2 am and I had to call her mother, who had never spoken to me (or probably even heard of me) before, to wake her up and get her out of bed to take my friend to the hospital to get her stomach pumped to get rid of whatever she tried to OD on. I will never regret that decision, especially since we're still friends seventeen years later, she's now happily married, and has three awesome children.------------------ · 1Belenen The point I am making is that you are not "letting" them do anything because it is not your choice.------------------Belenen Getting help for someone in crisis, if you have asked if it is okay to do so, is fine by me. Doing it against their will is a violation. It may be a violation you are okay with because you view the alternative as worse, but that doesn't make it right.------------------Matt I wouldn't use the term "Stockholm Syndrome" like Heather did, but I basically don't think that people who are pondering suicide are in full control of their own decision making abilities anymore. Mental illness is a disease. Would you let someone with paranoid schizophrenia injure themselves because they think the government implanted them with a tracking device, for example? I hope not, and I doubt you would. This is essentially the same thing. You're not in control of yourself if you're seriously contemplating suicide. You aren't making that decision with full access to your own brain. Therefore you can't give informed consent.------------------Matt If someone chooses to let me know they're thinking of suicide, they're giving me the option of getting them help, whether they claim to want it or not. I definitely do not see it as a violation, and even if it WAS one, it's a good one, because this is not a case of asserting your will, it's a case of a disease altering your will without your consent.------------------Belenen No. NO. People can sometimes impulsively commit suicide, but they can also do it with complete awareness. I CAN give informed consent to do any damn thing I want to my body because it is MINE and it never becomes someone elses. YES people CAN use their self-aware will to commit suicide.------------------Matt If someone is having suicidal thoughts and they let me know about it, they've given up some degree of control of the situation already. Once they do that, I'm going to make every effort to get them help, whether they think they want it or not.------------------Belenen That makes me feel incredibly unsafe around you. At any point if I seem suicidal to you you can just take actions I don't want? Not okay!------------------Matt I'm not setting up a dichotomy between impulsive or planned here because that's a false dichotomy. Most suicides are planned. It's rare for them to be a spur of the moment decision. I wonder how much actual knowledge you have of this issue. Whether or not you're committing suicide with "awareness," you're still not doing it with your full mental faculties intact, because depression or any mental illness alters your perception of life. It actually changes your brain in ways that can be viewed and studied.------------------Matt Of course I can. And I will, if I'm aware of it. As would pretty much anyone and everyone you know. Whether you think it's okay or not, people with clinical experience on this issue would vehemently disagree with you. It is never okay to just accept it when someone says they want to commit suicide.------------------Matt The ONE exception I can see in all this is when someone is terminally ill anyway and wants to end their life by physician assisted suicide. But that's a whole different kettle of worms that I'm not really prepared to go into right now.------------------Belenen my knowledge is firsthand. And I do not fucking care what the brain looks like. An altered perception does not give someone else the right to make decisions for my body, ever, and I don't give a flaming shit if people with 'clinical experience' would disagree.------------------Matt Should I have let my friend kill herself at 19 years old just because she wanted to and she made the decision to do it? I certainly will never be convinced that's the case.------------------Matt James, I would never let a mental illness influence you to take your own life if I became aware you wanted to do so. And that's because I care about you. I make no apology for that. I do not believe you can give informed consent to end your own life if you are depressed because the depression is actually stealing your ability to make healthy, informed decisions for yourself if it comes to that point.------------------Belenen Not your body, not your choice. This is so horrifying to me. I can't deal with you saying you would violate my consent because you thought you knew better than me how I should handle my life. I don't want you to know about my life anymore. I feel like I have to police myself so that I don't sound suicidal to you. Please unfollow me.------------------ · 1Matt That is my position and I'm sticking to it. I think you'll find many of your friends will agree with me, or at least I hope so. James, I really like you, so I'm going to disengage from this conversation, but I hope you'll think about what I said, and maybe actually look into some academic/clinical research on clinical depression, its affects on the brain, and the treatment of suicidal ideation, because everything you're saying goes against established knowledge and practice on the issue.

The last thing I'll say is that it makes ME feel unsafe that you would apparently not try to help me if I said I was suicidal and managed to convince you that I meant it. Because sharing that kind of information with someone is basically always a cry for help, whether a person realizes it at the time or not. And apparently, you would be unwilling or unable to help me unless I was able to express in the moment that I needed it, which I would not likely be able to do at that point if was suicidal.------------------Matt Oh, actually, one last thing, you've thus far refused to address whether or not I should have let my friend OD on prescription pills when she was on the phone with me when I was 19 years old. Please think about that.------------------Belenen I have not refused to address it. UGH. I said you cannot "LET" them because it is not your authority! And I said that you might consider it a necessary evil but that doesn't make it less evil. If my friend had taken a shitton of pills and was ODing, I would ask, and beg, to fetch help, but if they said no, I would not do it. If I was overcome with emotion, I might do it, but I would consider that a terrible violation and I would be extremely remorseful.

I have plenty of friends who have been suicidal who feel the same way I do, so stop trying to bring my friends into it -- they're not on your side. I've been there for people who were suicidal, and they didn't choose to do it despite my not telling them what to do or calling in authorities -- and if they HAD chosen to do that it would have been THEIR choice alone. I do not give a SHIT about "established practice" for crying out loud we're barely past locking people up for mental illness. Just because it maintains social values doesn't make it good practice.------------------Belenen I don't want to block you, because I would like to maintain incidental contact, but I do not feel safe with you watching what I have to say, so please unfollow me so that I don't feel the need to block you.------------------Topaz It is possible for someone to tell another person "I am going to kill myself" for reasons other than to roundabout ask for your help. Some people have severe, incurable mental illness, that CAN NOT be treated. It's more rare than treatable or manageable mental illness, sure, but it definitely exists. I don't want anyone I know to kill themselves, ever. But I'd rather my friends be honest with me if they planned on it, so I'd have a chance to say goodbye, maybe ask why, and get closure, and tell them I loved them. Maybe, if they trusted me to not stop them, and they told me, and I responded by saying I loved them.. maybe that love and respect would be enough for them to not want to die. Unfortunately, most people don't trust others to respect them, so they don't tell, and they kill themselves without telling anyone before.

I'm sorry that one of your friends tried to commit suicide when you were 19, and I'm happy for you that you feel you made the right decision. I don't know if your friend gave you consent or not to help her, but I can image that if your friend died, you would feel a lot of guilt. So for your situation, you made the right choice for you. I've had 5 people in my life commit suicide in the past 7 years. The most recent was last week. A dear friend hung themselves with no warning to friends or family. I wish he had the strength to ask for help, I miss him.

The one before that, I had a dear friend move out of the state and put a gun in his mouth within weeks. And you know what? I think this friend's suicide was the most caring, brave thing he could've done. You see, for his entire life, he fought the most horrific depression I've ever seen. At 15 he sought help, and he continued for 10 years. He tried every single therapy, medicine, counseling and method to try and get better, For 10 years, he fought. He attempted suicide more than 5 times in those 10 years. He tried overdosing on heroin, but a cop found him and called 911. He tried cutting himself, but his mom found him. He tried everything to die, and someone always stopped him. Each time, he'd try to get help, sincerely. After going through all the medicines, he eventually was left with shock therapy as his final medical option. He tried it, and it had adverse effects, sending him spiraling into such a mad, horrible depression that he was in pain constantly. It was like watching an animal flail in pain after getting run over. All of his friends watched as he flailed in immense pain for ten years. Most people can find a drug or medicine or therapy that AT LEAST minimizes or helps manage their pain. My friend couldn't. When he killed himself, we all felt a sadness for our loss, and a sigh of relief for his peace. He finally stopped suffering.

None of my friends who successfully died have told someone when they planned to commit suicide. Maybe if people weren't scared to talk about it, out of fear they would be forced against their will to "get help," then people would actually talk about it, weigh options, and make informed choices. I will talk, and hug, and help to the extent someone gives me permission, and I may even be bad and try to talk them into (logically) getting help. But I will never go against the will of someone I love. In my PTSD and depression, if anyone had ever FORCED me to get help, I'd be worse off and maybe dead. Since I was respected, I've healed some and am doing fine. Offering is one thing, forcing without consent is another.

Finally, I've had quite a few other friends who confided in me that they wanted to kill themselves. I told them that, because I was selfish, I didn't want to lose them, but I also told them that if that was ever their sure choice, to please let me know so I could give them one last hug. All have agreed, none have killed themselves. I also have taken friends to mental hospitals for them to get help for their depression or suicidal thoughts, with their consent, and only at their request.

So, my firsthand knowledge dealing with 5 suicides and at least a dozen people who have been or are suicidal, doesn't fit with what you say experts believe. Trust me, I've heard what experts have to say.

I'd love to help my friends get help, if they want it or are willing.------------------ · 1Matt If they confide in me that they're feeling that way, and I choose not to act, that is letting it happen. I consider that unethical and probably immoral. I'm really not interested in whether someone "wants" help when they're mentally ill. I'm going to get it for them whether they "want" it or not because they're not capable of making those decisions for themselves at that point. You CANNOT CONSENT when you are under the influence of mental illness. It's simply not possible.

I would imagine plenty of your friends are on "my side," as if there is really any such thing. I'm on the "side" of good mental health practice. We're talking about disease here, not making decisions when you're fully in possession of your faculties. It's two different things. We might be "barely past locking people up for mental illness," but we ARE past it, and if we have to wait a minimum amount of time before doing the right thing because we used to do the wrong thing, a lot of people are going to get hurt needlessly. It's got nothing to do with maintaining "social values." It has to do with treating people so they can overcome illness, which can't happen if they end their lives.

I'm not "following" you. We friended each other on here. I'm not interested in unfriending you, because I'm hoping we can continue to talk about this after we've both been able to take some time out to consider what's been said. But if you insist on not talking with anymore, go ahead and unfriend me. I won't "follow" you or bother you if you unfriend me, so you don't need to block me. But I would respectfully ask you to hold off on doing that, because I value your opinions on the issues we both care about. We disagree on this one, but I think we can still engage thoughtfully and constructively on it, or at least I hope so.------------------Belenen I don't want to hear any more from you on this topic Matt, you're making me feel incredibly depressed and unsafe, please STOP------------------Belenen by follow I mean the facebook follow where it shows you what I post------------------Belenen if I unfriend you it doesn't make you unfollow me because all my stuff is public------------------Matt I know what you meant. We're Facebook friends. I didn't just click "follow" on your profile. I said my position on unfriending you above. If you're determined not to interact with me, though, you can go ahead and unfriend me. But I hope you won't do that.------------------Matt If you unfriend me, I would have to hit "follow" on your profile to continue seeing your posts, which I wouldn't do. I'm not interested in bothering you, James, but I'm not interested in taking the active role of unfriending you, either. You'll need to be the one to do that if you feel the need to do so. If you do unfriend me, and I do continue to see your posts, I'll go ahead and "unfollow," but I don't think it works like that. But again, I hope you'll hold off, because I do enjoy talking to you and I consider you a friend. I just don't think you have the greatest take on this particular issue.------------------Anna What I find selfish is trying to make someone choose life when they don't want to. What one may think is a cry for help isn't always. I despise debating so I will not go back and forth on this.------------------ · 1Lily You know how you like to be treated, you know what makes you feel loved. It sounds like consent is a higher value to you than it might be to some people (not to say they don't value consent but perhaps it's higher on the list for you compared to values such as, say, staying alive). Which is cool, that's your values. It sounds like you want people to honour your agency to make decisions about your own life, and death, to the end. And to have people hear this and know this about you and dishonour that when you were in a suicidal space would not feel like a loving act.

We all seem to have different needs around this. It's so hard not knowing anyone else's. It would be nice if we could make up some kind of suicide will about what we consent to and what we do not in that event. For example, despite the fact that it is common procedure, I do not give prior consent to be hospitalized or to have other people notified about my state. I know that would not be helpful to me and I want others to know that. And yet, this is what people assume is the proper thing to do but they cannot know my life and how unhelpful that could be... However, I do give prior consent to use loving coersion (not hospitalization or notification) if I am in a place where it looks like I may hurt myself, because I know from having been there that, for me, this is actually what I need in the moment and I do *not* have agency over myself when I am considering acting on such things. I think we both know ourselves here.

So how do we deal with the vast majority of circumstances where we just don't know? And then getting it wrong? Like, ideally ask all our friends for prior consent about how to handle these situations? I don't have an easy answer... when I was with someone who was acutely suicidal and had taken pills I didn't decide anything, I just went straight to my heart and completely let my intuition guide me. I let whatever came out of me that needed to come out of me in that moment. And... what needed to come out, actually, wasn't coercive, and she ended up throwing up the pills...------------------Belenen If it is loving and respectful, it's not coercion. Talking people down is okay, as long as they consent to listen.

(Apparently Matt is not good at consent in general, because after I finally unfriended zir, ze followed me, and then stayed in the conversation 'liking' things. That is NOT what I asked for and not what ze said ze would do.)

Death is a basic human right. To live or not to live should ALWAYS be the choice of the person (unless they are taking up residence in someone else's body).

If you would feel okay calling some authority because I seemed suicidal, unfriend me, and leave me alone. I'm not okay with people taking control of my body and mind just because they think I'm 'disturbed.' Violating my consent is NOT the way to convince me that the world is worth living in. Thank Godde for Topaz in this conversation -- my hands were going cold and numb and I was shaking, and I read zir comment and it helped.

From personal experience, most of the time when I tell someone I want to kill myself, I don't want them to talk me out of it but I want them to make me feel important or give me all the reasons I shouldn't do it. I'd be pissed if someone called the cops on me though. On the other hand I have talked people into going to hospitals before. One even a few years later found me on Facebook and thanked me, because I guess him going there was good for him. I don't think I would ever call the cops on someone but I do often tell people full out honestly, "This may be selfish of me, but I don't want you not in my life" -- And I know it's selfish but some people I've grown so attached to, I cannot imagine life without them. Would I call the cops on them if they were truly going to do it? Probably not but I honestly could not handle being on the phone or in their presence when they were about to die -- sorry I am already mentally fucked and that would almost push me over the edge as well (screw me up mentally even more). That may also seem selfish but I am trying to stay alive here.

However, being within a master's of psychology program right now, I can kind of see where Matt is coming from. Right now we are even studying "informed consent" -- what it means to be able to give it, etc. Honestly, I think it may be possible for the other person to get in trouble, if they know someone is going to commit suicide and does nothing even. If that is true and would end up screwing my life up even more so than it is -- I may actually call the cops, etc. If I was sure I'd end up in jail or even possibly sued by their family or something. Probably also selfish but meh.

It's a fucked up world we live in! If depression is a mental illness -- which it is -- and a person is going to commit suicide without having exhausted all other options first (medication and therapy), I'd probably be kind of pissed off at them. Whether it's their choice or not. The one friend of yours who spoke of the person who DID exhaust all their options and ended up at the last resort, shock therapy, then I understand. It's a confusing subject for me, to say the least.

There is a huge difference between talking someone down and talking them out of killing themselves in my view and I don't think Matt has quite grasped that they are not necessarily the same thing. :/ It's not anybody's right to physically stop someone taking their life if that's what the person commiting suicide really wants and I believe true friends will know the difference between someone expressing a wish and wanting to be talked out of it and someone who really doesn't want to be talked out of it and is saying good bye. Those differences need to be respected.... 9 times out of 10 the people who really are going to go ahead with it don't tell anyone anyway and I have to wonder if this is why. :/

Thinking more on this and adding to my comment. When someone decides to kill themselves, they are in that moment thinking of what is best for them and since I on the other hand will be the one left alive, after their decision, why should I not think about what is best for me? Especially if their decision may somehow have consequences for me? And, to me, by default, everything humans do is ego, therefore it's all selfish. And, by definition it is a "selfish" act -- selfish meaning "(of a person, action, or motive) lacking consideration for others; concerned chiefly with one's own personal profit or pleasure." -- And, it may not be a "bad" thing per se, it being a "selfish" act. However, even though it's not for "profit" or "pleasure" it is an act solely concerned with oneself and lacking consideration for others, by definition anyway.

I am not saying your point of view is wrong - I don't think that. I just want to say that my personal point of view for myself is a bit different. In the past when I've wanted to kill myself I did feel as if my brain was impaired and when things got better I was very grateful that I did not act during that time. If I were to express I wanted to kill myself I would want my friends or family to involuntarily commit me to keep me from doing it. But that is my personal wish and certainly not how everyone thinks or feels. Just my 2 cents.

It's not clear to me how close Matt ever was to you, but if he was very close to you, it saddens me to see this issue end your relationship when he appears to have had good intentions and been honest with you (on the topic of suicide, anyway, if not on the topic of unfollowing you). Good intentions don't count for everything, of course, and it's important that you should be able to avoid feeling threatened by him. But good intentions do count for something, I think, and it's unfortunate if there really isn't any better way to resolve this so you can feel safe without having to cut off all contact with him.

I have always felt that people have the right to die if they so choose. I was relieved for Robin Williams when I had read that he suffered from depression and later reading that he suffered from Parkinson's as well.

I keep seeing this Aladdin photo of Genie and Aladdin hugging with the words "Genie, you're free". I thought that was really sweet because Robin Williams, the voice of Genie, is free from his pain now (or that is what I believe). Today my cousin posted an article about how that picture may cause people to choose suicide because it offers a way out of their pain...being set free. I didn't way to say anything because his dad ended his own life a few years ago and I know he is in pain about it still. But I don't think it's wrong to want your life and pain to be over.

My dad has attempted suicide a few times. Something has always stopped him. If it wasn't something like him not knowing how to handle or operate a gun, it was his call to the hospital or my sister for help. I'm glad he is still here but I know he's in terrible pain and he struggles every day. I want to respect his right to die should he choose that in the future but I don't know if I could make that decision, or really lack of decision, to not call 911. I hope I could and maybe with the thought of him in his current state, it would be easier to respect. But society ingrains in us to call for help and that doing that is the only option we have as bystanders.

I don't think suicide is just a choice for those who are terminally ill with cancer and whatnot. Can't we be terminally ill with depression? For some, it is life long and it gets worse and worse.

Sorry for the rambling. I agree with you and I'm glad I'm not the only one who feels this way. I've never mentioned this to anyone else before because it's so controversial. "Violating my consent is NOT the way to convince me that the world is worth living in. "

I'm having trouble understanding why Matt couldn't let it lie when it became obvious he was causing distress. I think maybe there's a 'Hollywood movie' version of mental illness that is probably the closest most people come to experiencing it. So many movies display the 'raving lunatic' model, with no middle ground and shows people incapable of sensible decisions. I guess this has made people think they're 'saving' others by removing their autonomy.

Topaz's comment was a breath of fresh air, showing that you can compassionately talk to someone without having them effectively kidnapped by authorities. A bit of trust and kindness is better than force, and doesn't leave the lingering aftertaste.

I've having a hard time resolving this one. I have to start off with saying that I can't say for absolute what I would do if panicked, the one time somebody told me they were thinking of hurting themselves I called counselors and friends rather than police, and think I would probably do so again.

I can think of a couple of devil's advocate cases:- In a very general sense, the lack of informed consent is an acceptable argument. Similarly, I would prevent a baby from touching a stove, or tackle a blind person if they were about to step in front of a moving vehicle. Counterpoint below.- I don't like the idea of people absolutely relinquishing their autonomy. I can accept it for potential play, or even as necessary in certain emergency situations or places that require an authority structure. But leaving the door open for slavery, capitalist or otherwise, could be a problem. In the same vein, if a person no longer agrees to a situation, but has no way out of it, and it could be argued a human is different people at different times, the later person is no longer consenting. And specifically in line with the suicide discussion, there's a lot of people who survived suicide jumps who said they regretted their decision.

That being said: I totally agree with the possibility you suggested of instant-decision. I also reject his declaration that suicide is necessarily the result of mental illness and the abdication of forethought - while it wouldn't be for me (I still have too much to read), I can see it being a perfectly rational decision for someone.

This discussion has just helped me talk with a bipolar friend who has been suicidal several times, and clear consent issues on their end.

I will repeat what was already said: this is a breath of fresh air. It helps, strongly, to really look at the issue, and not be blindsided by the society's general, um, outraged refusal to accept suicide in any way.

So for now I will draw this conclusion for myself: if I now someone who is suicidal, I will try to help any way I can without outright talking about it, and pray for them. And then when (if) they are in a better place, talk about what they want if they become suicidal again.